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CVS Prescription Class Action Lawsuit

By Kimberly Mirando

CVS Caremark forces its insurance subscribers to fill their prescription at CVS Pharmacies, according to a proposed class action lawsuit filed in West Virginia.

Six privately owned pharmacies and six registered pharmacists filed the class action complaint against CVS Caremark and CVS Pharmacies, alleging the group engaged in unfair business practices. Specifically, they say, the group participates in a continuing scheme to unlawfully force certain West Virginians into using CVS-owned pharmacies in order to have most, if not all, of their prescriptions filled.

According to the CVS class action lawsuit, patients who have coverage with CVS Caremark, one of the largest pharmacy benefits administrators in the country, attempted to get prescriptions filled at pharmacies other than CVS, but were told Caremark would not pay for the prescription unless it was filled at a CVS pharmacy or through a CVS mail-order system. The patients were allegedly told if they wanted their prescription filled they had two options: find the nearest CVS pharmacy or pay the total cash price for the medicine.

The CVS class action lawsuit says state law prohibits pharmacies and pharmacists from entering into agreements or participating in activities that deny, limit or influence a patient’s selection of pharmacies or for the “servicing or counseling by a pharmacist of his or her choice.”

These CVS practices eliminate West Virginia patients’ rights to choice their own pharmacist or pharmacy, the class action lawsuit claims.

The proposed class action lawsuit is seeking unspecified damages.

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Updated May 2nd, 2011

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9 Comments

I’ve had the same problem since day one with CVS caremark. The only difference is I live in MN. This company has put me through hell and back and my health is suffering as a result.

I think it’s time I fight back and file my own lawsuit against this company. It goes way beyond just being forced to fill it via mail. I have plenty of proof to back me up and maybe CVS caremark needs to quit playing this game before myself or anyone else is seriously hurt or killed.

Who knows…considering just how big this problem has become for me I might find a way to go national and get this in front of everyone, not just on internet.

Caremark is a terrible company with terrible policies. Not only do they ship without asking for payment, but when you try to pay with your FSA card, they then deny it, saying you can not pay for medicine with the card after the fact. They also refuse to give me the medicine my doctor has prescribed, giving me instead what they think I need. I can not get more, even if I go to a non-CVS pharmacy. I filed a grievance with them and my companies health plan provider, but to no avail.

I too, am having issues with Caremark. I’ve been on the same prescription for almost 10 yrs and with no notice it has now been denied. They have agreed to give me the same medicine in a patch which I can’t use because I’m allergic to the adhesive (not to mention it doesn’t help with break-through pain). I’ve been fighting to get the prior authorizations approved but they keep being denied. My doctor did a peer to peer to try and get this reinstated for me but to no avail.
My loving husband bought me 5 days worth for $900. (Didn’t get the insurance discount). this has gotten so bad for me I’m going to lose my pain doctor which I’ve had for almost 10 yrs. I’m a law abiding citizen no tickets, or arrest and my only request is “please allow me to use this medication, so I can have some kind of dignity & because without it I can’t bathe, without so much pain I can barely breath”. I am limited to how much I can walk and without this I can’t leave the house except for dr. appts. They made me go through withdrawals that are so bad I don’t know if I’ll be able to live through this next withdrawal time which will begin in approximately 17 days.
Each time I have to go through these withdrawals they get worse. This last time, only days ago, I barely made it. It’s against the law for the doctor, pharmacy or me to have a 3 mos supply on hand of this medication but yet that’s what they want. Then they came up with the excuse that it’s only for cancer patients which isn’t true either. How can it be approved in other means (e.g. shots, patches)and not allow me to have it in the only way I can take it? I would like an attorney to back us patients that are having this issue because it isn’t right that their interfering with what my doctor is prescribing and my Quality of life which is so nile it’s almost non existent. I have no social life anymore because of pain. I didn’t ask to live in pain nor did I do anything to cause my life of pain it’s just my life.
I’ve fought to live so I can see my children grow up and all be damned if a corporation is going to dictate what makes my life bearable, not enjoyable but bearable! I believe it’s wrong that the patient isn’t a part of the prior authorization process. My doctor can’t remember everything he’s done but me on the other hand I can, I also know what horrible things I endured, medications that I had reactions to and selective nerve blocks that left me bedridden for 3 months before they fixed it. All of these things have left me with aniexty, (I can’t get over) and weakness because I can’t do much of anything, and I’m sure my life-span has been shortened because of Chronic pain!! So why should Caremark dictate my Quality of life?? My doctor wrote a script and I have good insurance but I can’t have it so the alternative is to suffer until I die of natural causes or withdrawals from this medication. Either way I feel like this is medical negligence..

I am having issues with CVS/Caremark & BC/BS. They are telling me that because I have a certain tier medication for HIV that I now have to get it filled via their specialty pharmacy, pay out of pocket, or go without. I need this drug to survive. I feel comfortable with my pharmacist because I have a personal relationship with them and I trust them. They told me it was part of my new plan for 2014 and that I had no other choice. They are discriminating against me because I have HIV and it requires drug management which I get at my pharmacy which is certified in HIV. I don’t know what to do. I hate the helpless feeling that the decisions for my healthcare are no longer mine to make.

I just started having a similar problem as yours. Went to refill my three HIV meds through their specailty pharmacy and was told that one of them is no longer on the formulary and that my co-pay would be over $2000.00 I am still appealing this decision with CVS&BC but it has yet to be resolved. I currently have less than a 30 day Supply left

I am having a similar problem as yours, started in Feb, 2015. Called in a refill of meds to caremark mail order that I have been using for years, I was told they can not fill my refill. I found out that for us in Florida starting this year we have to get our meds through their Caremark specialty pharmacy and I have to pay almost $700.00 for just a 30 day supply, I use to pay $40.00 for a 90 supply. I am also appealing this decision with caremark, now going on over a month, have to go off meds soon. I just wanted to ask how your case decision ended up, and if you think I should speak to an attorney.

CVS pharmacy is so prejudice, rude, and slow! Even pharmacists are rude and uncaring. I was in front part of the store and the sales clerk was watching me as if I was going steal stuff. I am a regular customer but that was a new one that I was visiting so she didn’t know me. Plus my husband and I spend over $200 a month in prescriptions alone. We do not want buy anything there anymore. Unfortunately our insurance works with them. CVS is the only one that I can go to for a 90-day supplying. I am calling my insurance company so they will open that program to other pharmacies. How do I join the class action suit?